People v. Ekong

582 N.E.2d 233, 221 Ill. App. 3d 559, 164 Ill. Dec. 25, 1991 Ill. App. LEXIS 1960
CourtAppellate Court of Illinois
DecidedNovember 19, 1991
Docket3-91-0216
StatusPublished
Cited by5 cases

This text of 582 N.E.2d 233 (People v. Ekong) is published on Counsel Stack Legal Research, covering Appellate Court of Illinois primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
People v. Ekong, 582 N.E.2d 233, 221 Ill. App. 3d 559, 164 Ill. Dec. 25, 1991 Ill. App. LEXIS 1960 (Ill. Ct. App. 1991).

Opinion

PRESIDING JUSTICE STOUDER

delivered the opinion of the court:

The defendant, Dr. Edwin Ekong, was held in contempt of court for failing to comply with a subpoena duces tecum issued by a Kankakee County grand jury. The court ordered the defendant incarcerated until he purged himself of contempt. The defendant was subsequently released on bond pending this appeal.

On January 16, 1991, Special Agent Jim Terry of the Illinois State Police, Assistant Attorney General Pat Jennings and other police officers searched the defendant’s office pursuant to a search warrant and removed all current and past billing records for a five-year period which related to both medicaid and nonmedicaid patients. The defendant was served with a grand jury subpoena duces tecum commanding him to bring to the grand jury on January 25, 1991, all patient files, records and sign-in sheets of medicaid patients treated by him or otherwise treated at the medical clinic during the period of January 1, 1986, through January 15, 1991. The grand jury was investigating possible medicaid fraud on the part of the defendant.

On February 8, 1991, the defendant presented a motion to quash the subpoena, which requested the return of his patient files and the other items seized. The trial court denied the motion and found that the defendant must comply with the subpoena to the extent of turning over approximately 1,000 patient files to the grand jury.

The defendant asserted the statutory physician-patient privilege (Ill. Rev. Stat. 1989, ch. 110, par. 8 — 802) (privilege) as a basis for refusing to comply with the subpoena. The trial court found the privilege to be in conflict with Federal law. The court found that the purpose of the Federal legislation (the prevention of medicaid fraud) would be thwarted by enforcement of the privilege under these circumstances. Therefore, under the supremacy clause of the United States Constitution, article VI, the privilege fell and the court ordered the defendant to comply with the subpoena.

The defendant claims the privilege exempts him from releasing the requested information to the grand jury. Although no similar privilege existed at common law, the physician-patient privilege provides that no physician or surgeon shall be permitted to disclose any information he or she may have acquired in attending any patient in a professional character, necessary to enable him or her professionally to serve such patient. (Ill. Rev. Stat. 1989, ch. 110, par. 8 — 802.) A number of exceptions are listed within the statute; however, none applies in the instant case.

We must address whether the privilege can prevent the subpoenaing of a physician’s records of patient treatment during an investigation of alleged medicaid fraud in which applicable Federal law requires disclosure. We hold that under the supremacy clause, Federal law prevails and that the medical records in the defendant’s possession are obtainable by the grand jury.

When confronted with a situation wherein a State law conflicts with Federal law, the United States Supreme Court has stated that we must “determine whether under the circumstances of this particular case [the State’s] law stands as an obstacle to the accomplishment and execution of the full purposes and objectives of Congress.” (Jones v. Rath Packing Co. (1977), 430 U.S. 519, 51 L. Ed. 2d 604, 97 S. Ct. 1305.) This inquiry requires that we consider the relationship between State and Federal laws as they are interpreted and applied, not merely as they are written. (Jones v. Rath Packing Co. (1977), 430 U.S. 519, 51 L. Ed. 2d 604, 97 S. Ct. 1305.) When the State law prevents the accomplishment of the full congressional purpose, it must yield to the Federal law. Jones v. Rath Packing Co. (1977), 430 U.S. 519, 51 L. Ed. 2d 604, 97 S. Ct. 1305.

A review of the Federal medicaid laws and regulations discloses a clear congressional intention that the patient records kept by health-care providers be subject to disclosure during fraud investigations. (See In re Grand Jury Investigation (R.I. 1982), 441 A.2d 525.) The regulations set forth State plan requirements, standards, procedures, and conditions for obtaining Federal funds. (42 C.F.R. §430.0(b)(l) (1991).) One requirement is that the disclosure of patient records be for “[conducting or assisting an investigation, prosecution, or civil or criminal proceeding.” 42 C.F.R. §431.302 (1991).

Regarding criminal investigations, Federal law provides for the creation of a State medicaid fraud-control unit to protect the program from fraudulent practices. (42 U.S.C.A. §1396b(q) (West Supp. 1981).) This section provides inter alia that the fraud-control unit is to: (1) possess statewide authority to prosecute individuals for criminal violations; (2) remain separate and distinct from the State agency; (3) investigate and prosecute all aspects of fraud in connection with the medicaid program; (4) act upon complaints of patient abuse or neglect under the criminal laws of the State; and (5) employ the necessary personnel and be organized in such a manner as will promote effectiveness and efficiency. 42 U.S.C. §1396b(q) (1988).

These statutory requirements are expanded upon in the regulations. Section 455.21(a)(2) of the Code of Federal Regulations provides in part that when a fraud-control unit determines that patient records may be useful in investigations of suspected fraud, it shall have:

“[a]ccess to any information kept by providers to which the agency is authorized access ***. In using this information, the unit must protect the privacy rights of recipients.” 42 C.F.R. §455.21(a)(2)(iii) (1991).

Furthermore, a State plan must provide for an agreement between the medicaid agency and each provider furnishing services under the plan (including individual practitioners), in which agreement the provider agrees to:

“(1) Keep any records necessary to disclose the extent of services the provider furnishes to recipients; [and]
(2) On requests, furnish to the Medicaid agency, the Secretary, or the State Medicaid fraud control unit *** any information maintained under paragraph (b)(1) of this section and any information regarding payments claimed by the provider for furnishing services under the plan ***.” 42 C.F.R. §431.107 (1991).

In addition, we find the trial court correctly adopted the findings of the Rhode Island Supreme Court case In re Grand Jury Investigation (R.I.

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582 N.E.2d 233, 221 Ill. App. 3d 559, 164 Ill. Dec. 25, 1991 Ill. App. LEXIS 1960, Counsel Stack Legal Research, https://law.counselstack.com/opinion/people-v-ekong-illappct-1991.